Laparoscopic assisted colorectal surgery

Forty-nine consecutive patients underwent laparoscopic assisted colorectal surgery for benign and malignant lesions of the colon. Thirty-eight of the 49 operations (78%) were completed successfully with laparoscopic assistance. A large tumor bulk or dense adhesions were the most common reasons for conversion to laparotomy. Twenty-eight of the 38 patients (74%) in the laparoscopically completed group were tolerating a diet by postoperative day 2, and 31 (82%) passed flatus or a bowel movement by the third postoperative day. The mean postoperative hospital stay for this group was 4.8 days, which compared very favorably to that reported in the literature for traditional open colorectal operations. Twelve patients developed complications, for a 24% morbidity in the series. However, only 3 (6%) of these complications were related to the laparoscopic part of the procedure. Inspection of the pathologic specimens revealed adequate margins and a lymph node harvest that averaged 11 nodes per specimen. We concluded that laparoscopic assisted colorectal surgery is a safe and feasible technique, which may be associated with a faster return of bowel activity and a shorter hospital stay. Although the extent of resection appears comparable to that of laparotomy, it is too early to assess long-term outcome when it is applied in the treatment of malignancy.